Can health-related quality of life predict survival in adults with cystic fibrosis?
BACKGROUND
Advances in the management of cystic fibrosis have led to a significant improvement in survival, although marked differences between individuals are still observed. The value of patient-reported health-related quality of life scores in predicting survival in adults with cystic fibrosis is unknown.


OBJECTIVE
To evaluate whether patient-reported health-related quality of life could predict survival in cystic fibrosis.


METHODS
From 1996 to 1997 a consecutive series of 223 patients were recruited to evaluate the Cystic Fibrosis Quality of Life Questionnaire. Demographic (age, sex), clinical (FEV(1)% predicted, body mass index, diabetes, B. Cepacia complex, intravenous access device, nutritional and lung transplant status) and health-related quality of life variables were recorded (Cystic Fibrosis Quality of Life Questionnaire and the SF-36). These data were used as baseline measures to explore the prognostic association of health-related quality of life and subsequent survival.


RESULTS
At the census date (December 31, 2006) 154 (69.1%) adults were alive, 66 (29.6%) had died, and three (1.3%) were lost to follow-up. Cox proportional hazards models and bootstrapping procedures examined if health-related quality of life domains predicted survival after adjusting for the demographic and clinical factors. The physical functioning domain of the Cystic Fibrosis Quality of Life Questionnaire and the pain domain of the Short Form-36 had the strongest statistical associations with survival.


CONCLUSIONS
Aspects of patient-reported quality of life serve as prognostic measures of survival beyond a number of previously known factors in cystic fibrosis. This needs to be investigated further in a larger longitudinal study.
Abbott
Janice
J
Faculty of Health, University of Central Lancashire, Preston, United Kingdom. jabbott@uclan.ac.uk
Hart
Anna
A
Morton
Alison M
AM
Dey
Paola
P
Conway
Steven P
SP
Webb
A Kevin
AK
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D010147:Pain Measurement; D016016:Proportional Hazards Models; D011788:Quality of Life; D055815:Young Adult